| NPI | 1083399612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME182340) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.082673) |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2026-08-03 |